Etiologies and Outcomes of Acute Respiratory Failure in Solid Organ Transplant Recipients: Insight Into the EFRAIM Multicenter Cohort

Massimo Antonelli, Messika 1 Jonathan, Darmon 2 Michael, Mal 3 Hervé, Pickkers 4 Peter, Soares 5 Marcio, Canet 6 Emmanuel, Rello 7 Jordi, R Bauer 8 Philippe, van de Louw 9 Andry, Lemiale 2 Virginie, Silvio Taccone 10 Fabio, Martin Loeches 11 Ignacio, Schellongowski 12 Peter, Mehta 13 Sangeeta, Kouatchet 15 Achille, Barratt-Due 16 Andreas, Valkonen 17 Miia, Bruneel 18 Fabrice, Pène 19 FrédéricMetaxa 20 Victoria, Sophie Moreau 21 Anne, Burghi 22 Gaston, Montini 15 Luca, Barbier 23 François, B Nielsen 24 Lene, Mokart 25 Djamel, Chevret 26 Sylvie, Zafrani 2 Lara, Azoulay 2 Elie, EFRAIM Investigators and the Nine-I Study Group

Risultato della ricerca: Contributo in rivistaAbstract

1 Citazioni (Scopus)

Abstract

Background: Respiratory complications of solid organ transplant (SOT) are a diagnostic and therapeutic challenge when requiring intensive care unit (ICU) admission. We aimed at describing this challenge in a prospective cohort of SOT recipients admitted in the ICU. Methods: In this post hoc analysis of an international cohort of immunocompromised patients admitted in the ICU for an acute respiratory failure, we analyzed all SOT recipients and compared their severity, etiologic diagnosis, prognosis, and outcome according to the performance of an invasive diagnostic strategy (encompassing a fiber-optic bronchoscopy and bronchoalveolar lavage), the type of transplanted organ, and the need of invasive ventilation at day 1. Results: Among 1611 patients included in the primary study, 142 were SOT recipients (kidney, n = 73; 51.4%; lung, n = 33; 23.2%; liver, n = 29; 20.4%; heart, n = 7; 4.9%). Lung transplant recipients were younger than other SOT recipients, and severity did not differ across type of received organ. An invasive diagnostic strategy was more frequently performed in lung transplant recipients with a trend toward a higher rate of bacterial etiology in lung than kidney transplant recipients. Overall ICU survival of SOT recipients was 75.4%. Invasive diagnostic strategy, type of transplanted organ, and need of invasive mechanical ventilation at day 1 did not affect ICU prognosis. Conclusions: ICU management of hypoxemic acute respiratory failure in SOT recipients translated into a low ICU mortality rate, whatever the transplanted organ or the acute respiratory failure cause. The post-ICU burden of acute respiratory failure SOT recipients remains to be investigated.
Lingua originaleEnglish
pagine (da-a)2980-2987
Numero di pagine8
RivistaTransplantation Proceedings
Stato di pubblicazionePubblicato - 2020

Keywords

  • Etiologies, Outcomes, Acute Respiratory Failure

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